World Neurosurg
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Brain plasticity is an ongoing process of reorganization not only on the macroscopic level but also from underlying changes at the cellular and molecular levels of neurons. This evolution has not yet been fully understood. The objective of this paper is to review and understand neuroplasticity through the review of literature, imaging, and intraoperative evidence.
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Anterior cervical discectomy and fusion (ACDF) are increasingly performed at ambulatory surgical centers (ASCs). Academic centers lacking dedicated ASCs must perform these at large university hospitals, which pose unique challenges to cost savings and efficiency. ⋯ Academic centers without dedicated ASCs can safely perform ACDF as a same-day or overnight observation procedure with significant reductions in cost. The lack of a dedicated ASC should not preclude academic centers from allocating appropriately selected patients into same-day or overnight observation care pathways. This strategy can improve resource utilization and preserve precious hospital resources for the most critically ill patients while also allowing these centers to build viable outpatient spine practices.
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The response to the global severe acute respiratory syndrome coronavirus 2 pandemic culminated in mandatory isolation throughout the world, with nationwide confinement orders issued to decrease viral spread. These drastic measures were successful in "flattening the curve" and maintaining the previous rate of coronavirus disease 2019 infections and deaths. To date, the effects of the coronavirus disease 2019 pandemic on neurotrauma has not been reported. ⋯ Population seclusion had a direct effect on the frequency of neurotrauma, whereas the change in relative proportion of certain mechanisms may be associated with the psychosocial effects of social distancing and quarantine.
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Comparative Study
Comparison of Decompression versus Decompression and Fusion for Lumbar Synovial Cysts and Predictive Factors for Cyst Recurrence.
The management of lumbar synovial cysts (LSC) has been a controversial topic for many years. Whereas many authors label LSC as markers of instability and thus necessitating fusion, others suggest that decompression alone without fusion is a viable initial treatment option. Our objective was to clarify outcomes in patients undergoing decompression alone and decompression with fusion for symptomatic LSC and identify factors for cyst recurrence. ⋯ Decompression alone is a reasonable choice for the initial management of LSC, although it does carry a significant risk of same-level reoperation due to cyst recurrence and spondylolisthesis. Preoperative coronal facet inclination angle may be a useful measurement in predicting cyst recurrence following decompression.
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Abnormal hematologic parameters associated with unfavorable neurological outcomes in traumatic brain injury (TBI) have been studied in isolation. We aimed to study whether there are any additional parameters that improve standard prognostic models in TBI. ⋯ International normalized ratio, total leukocyte count, and blood transfusion were found to be predictors of mortality and unfavorable neurological outcome in TBI at 6 months. Their addition to the IMPACT and CRASH prognostic models resulted in a modest improvement in the prediction of outcome in TBI.